Dr. Oz Grilled On The Hill

I met Dr. Mehmet Oz once, at the first Forbes Healthcare Summit. He dropped in on a pre-event soiree to say a few words to the attendees. He was much taller than I had supposed, making it easy to spot him in a crowd, so I pushed my way through and introduced myself (our host, Steve Forbes, was also making his way over so I knew I would only have a brief opportunity). I shook his hand and praised him as an excellent communicator, but expressed concern about his message. Whatever else Dr. Oz might say during his show, my patients heard only about the "latest weight loss miracle." His response: "Well, I don't endorse any products." The Forbes' arrive, I am carried away by the crowd.

When we use the more rational bits of our brains, we know that any miracle that is supplanted by another in a couple of months needs a new name ("You keep using that word..."). We in the reality-based medical community are often seen as wet blankets, continuously critiquing the charismatic heart surgeon for his irresponsible boosterism of useless (but not free) supplements and procedures. Today, we left the role of Cassandra behind.

Many of us were worried when Dr. Oz was invited by Senator Claire McCaskill (D-Missouri) to testify in front of a consumer protection panel about weight loss scams. A small part of my held out hope that the invitation might hold some surprises for Dr. Oz, and thankfully it did. Rather than ask Oz for his expert opinion about the current threat of weight loss scams, Dr. Oz was set up as another sort of expert: a promoter of these scams. (NB: quotes transcribed by me)

Senator McCaskill: You are being made an example of today because of the power you have in this space. We didn't call this hearing to beat up on you but we did call this hearing to talk about a real crisis in consumer protection. You can either be part of the police here or you can be part of the problem.

Ouch.

Senator McCaskill isn't some starstruck fan. She did her homework, and she brought her A-game. The senator started out by quoting to Dr. Oz a number of his "miracle" weight loss proclamations. Take a look at the whole exchange:

Dr. Oz: Well, if I could disagree about whether they work or not, and I'll move on to the issue of the words that I used. And just with regards to whether they work or not, take green coffee bean extract as an example. Uh, I'm not gonna argue that it would pass FDA muster if it was a pharmaceutical drug seeking approval, but among the natural products that are out there, this is a product that has several clinical trials. There was one large one, a very good quality one, that was done the year that we talked about this, in 2012. Listen, I've...

Sen. McCaskill: wh..wha..I wanna know about that clinical trial. Because the only one I know was sixteen people in India that was paid for by the company that, that was in fact, at the point in time when you initially talked about this being a miracle, the only study that was out there was the one with sixteen people in India that was written up by somebody that was being paid by the company that was producing it.

Dr. Oz: Well, this paper argue that there was no one paying for it, but I have the, four papers, five papers actually plus a series of basic science papers on it as well. But, but Senator McCaskill, what, if I, we can spend a lot of time arguing the merits of whether green coffee bean extract is worth trying or not worth trying. Maybe the things that we argue you do with regard to your diet are likewise criticizable, I mean should you be on a low fat diet, a low carb diet, we b...I spent a good part of my career recommending that folks have a low fat diet, but we've come full circle in that argument now and no longer recommend that now, many of us who practice medicine because it no longer worked for our patients. Now it is remarkably complex, as you know, to figure out what works for most people even, in a dietary program.

In the practice of medicine we evolve by looking at new ideas and challenging orthodoxy and evolving them. So...so when I hold...these are the five papers, these are clinical papers, uh, and we can argue about the quality of them, very justifiably, uh, I could pick apart papers that showed no benefit as well, but, at, at the end of the day, I have clinical subjects, real people, having undergone trials, and in this case I actually gave it to member of my audience it wasn't a formal trial, it was just an exch...

Senator McCaskill: Which wouldn't pass...the trial you did with your audience, you would not say that it would ever pass scientific muster.

Dr. Oz: No, I would never publish the paper. It wasn't done under the appropriate IRB guidance, that wasn't the purpose of it. The purpose was for me to get a thumbnail sketch, was this worth talking to people about or not. But again I don't think this should be a referendum on the use of alternative medical therapies 'cause if that's the case then I've been criticized for having folks come on my show and talk about the power of prayer. Now again as a practitioner I can't prove that prayer helps people survive an illness, I..

Senator McCaskill: Sure, but it's hard to buy prayer.

Dr. Oz: Hard to buy prayer. That's the difference.

Sen. McCaskill: Prayer is free.

Dr. Oz: Yes, prayer is free, that's a very good point.

This brief exchange reveals a lot about how Oz, charlatans, and snake oil salesmen work. They evade. They ignore the question and answer their own. He cited studies and when he was called out on what appears to be a blatant lie, he simply changed the subject.

This is not the behavior one would expect of what the Senator called "someone trained in science-based medicine". I'll admit, it was good to see him sweat. But I hope that isn't his final discomfort.

McCaskill said, "I don't get why you need to say this stuff, 'cause you know its not true."

To her I would ask, Cui bono? Is it only Dr. Oz and the companies who just happen to benefit from the products that he "doesn't endorse?" I certainly don't know, but I hope someone keeps asking.